Standard HMOs
Depending on where you live or work, in many parts of the State, you
may also select a Standard HMO.
With a Standard HMO you must use network providers to receive benefits
- no benefits are paid when you use out-of-network providers. In addition,
set dollar copays keep your costs more predictable.
Plan Highlights
| Covers care received in network only |
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No annual deductible
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What you pay for care received
- Doctor office visits
- Hospital stay
- Prescription drug
- generic
- preferred brand
- non-preferred brand
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- $15/visit for PCP; $25/visit for specialists
- $250
- $10/retail; $20/mail order
- $25/retail; $50/mail order
- $40/retail; $80/mail order
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Annual out-of-pocket maximum
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Preventive care: routine physical exams, health screenings and
immunizations at specified intervals
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See the HMO's certificate of coverage for specifics for the HMO
you are considering
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View a list of the Standard HMOs that will be offered
in 2008 and the areas where each is available. The 2008 Benefit Statement
you receive in late September 2007 will show the specific HMO options
available to you.
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